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Effective Date: 
10/2002

Documents

Instructions

Updated: 10/2002

Purpose

To request information from the Railroad Retirement Board regarding the amount of an applicant/recipient's benefits.

Procedure

Number of Copies

The worker completes an original and one copy of Form H1026.

Transmittal

The worker sends the original to the Railroad Retirement Board and keeps the duplicate in the case record. Attach Form H0003, Authorization to Furnish Information, (signed by the applicant, recipient, or responsible person) to the original. If the worker does not know the regional office address, he sends the original to Railroad Retirement Board, 844 Rush Street, Chicago, Illinois 60611.

Form Retention

Form H1026 is kept in the case record for three years after the recipient's eligibility is denied.

Detailed Instructions

To — Enter the address of the regional office of the Railroad Retirement Board.

From — Enter the worker's name and local office mailing address.

Applicant/Recipient Information — Enter the retiree's name, address, payee name if different, Railroad Retirement Claim number, and Social Security number.

The worker signs the form and enters the date and his telephone number. A Railroad Retirement Board representative completes the other items on the form.